My cold is worse than yours, because it’s happening to me!

It’s been a miserable week for some. My dear wife J has, for some time now, struggled with the dreadful non-Covid cold that’s doing the rounds at present. Like many others who have caught the cold, it knocked her for six and unlike her, she spent long periods in bed exhausted. We ruled out Covid through almost daily testing. Thankfully she is slowly getting better, but it has certainly taken its toll on her general health and wellbeing. J and people like her who have struggled with this cold represent what I think is a looming respiratory disease iceberg, more of which later.

First, I should think the whole of the African continent was feeling miserable, following the news last Tuesday, that the disgraced former health secretary, Matt Hancock, is set to become a United Nations special representative to Africa. It appears that although Hancock accepted the role on 7th October, I have to ask why he waited until last Tuesday announce it.  The cynic in me wonders if it had anything to do with the publication of a highly critical cross party report on the UK government’s handling of the pandemic; a government he was part of and in which he took a leading role. Perhaps Vera Songwe (the Under Secretary General of the UN) was unaware of the inquiry and report when she penned a letter to Hancock saying, ‘your success on the UK’s response to the Covid 19 pandemic and the acceleration of vaccines that has led the UK move faster towards economic recovery is one testament to the strength that you will bring to this role’. However, yesterday it seems the UN withdrew its offer of a job. I think rightly so as the UK has the second-highest coronavirus related death toll in Europe, with only Russia having a higher death rate.

Closer to home, I would imagine many GPs will be feeling even more miserable than they might have been with the continued call from the media and the current Secretary of State for Health and Social Care, Sajid Javid, for GPs to see more people face2face. The £250 million so-called ’rescue plan’ for primary care (which works out at around £3.66 per patient per year) is unlikely to resolve the long-standing problems, and speaks to a lack of understanding of the issues facing doctors and other primary and community care professionals. We have been here before.

How many of you remember the 'General Practice: Forward View' published in 2016? It is a really good read, even today. It still reflects today’s issues well, and proposed significant investment in terms of both additional GPs and other health and care professionals, as well as in new technology. The paper is full of case studies showing what was being achieved using virtual consultations, remote clinical triaging and using technology to better manage long term conditions. More recently (July 2020), when he wasn’t busy doing things he shouldn’t have been doing, Matt Hancock was urging GPs to make all consultations virtual consultations by default. The reality has been somewhere in between. GPs have continued to see patients face2face all the way through the pandemic, but many practices have also provided remote clinical triaging to ascertain whether a face2face consultation is necessary. Likewise, many patients have liked the flexibility and ease of access that virtual consultations bring. It’s also worth remembering that despite the big rise in people presenting at Emergency Departments recently, typically there are only 23 million A&E visits a year, compared to over 300 million patient consultations being provided in primary care each year. Such flexibility benefits everyone and is not something to be sneezed at.

Oh yes, let’s return to what I was saying about colds. I can safely predict that colds, flu and every kind of respiratory condition in between are going to be a problem this winter. We have already seen a huge increase in children presenting at Emergency Departments with all kinds of sniffles, coughs and so on. As children and adults have started to mix more, and without the restrictions that have been in place since March last year, it’s not surprising that we are now seeing this increase in colds. And there’s the (vapour) rub.

This horrible cold brings with it similar symptoms to those of Covid 19. Even if you are vaccinated, you can still catch Covid 19. Indeed, Covid symptoms can feel very similar to a cold or flu. Hence in our house, J has tested herself every couple of days. The symptoms of Covid 19 can include: a headache, sneezing, sore throat, runny nose, cough and fever. Sounds like a cold or flu doesn’t it? However, anosmia (loss of taste, or smell) is one of the more differentiating symptoms – this tends to happen with Covid 19, so maybe an important symptom to aware of. Thankfully, it is also not one that J has experienced. Those good folk over in ZOE have detailed the 21 most common symptoms of Covid 19, see here.

However, here is my first public health message: If for what ever reason you are feeling unwell, whether it’s a cold, flu, or Covid 19, get tested, stay at home, and stay there until the symptoms subside. Our J felt well enough last week to go back to work, but very sensibly, did so remotely. Public Health message No 2: if you have these symptoms, don’t go to your GP! Get on the phone (it might take you a little longer to get through, but you will get there) or go online. Don’t get frustrated and take yourself off to A&E, as you are likely to be in for a very long wait. Many of the issues that folk seek help from their GP for are self-limiting; you will get better without anything other than ‘over the counter’ medications, sleep and plenty of fluids.  This is true even if, unlike J, you don’t live with a nurse. Remember, as the NHS website notes: ‘if general practice fails, the NHS fails’, and I for one am determined that won’t happen.